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[圣犹达医疗公司人工心脏瓣膜在主动脉和二尖瓣部位的早期及晚期效果]

[Early and late results of St. Jude Medical prosthesis in aortic and mitral portion].

作者信息

Kuboyama I, Sese A, Masaki H, Kohda Y, Ueno Y, Imoto H

出版信息

Rinsho Kyobu Geka. 1989 Aug;9(4):374-80.

PMID:9301945
Abstract

January, 1980 to December, 1988, 118 patients underwent aortic (AVR) (45), mitral (MVR) (55), aortic and mitral (DVR) (21) valve replacement with a tilting disc valve prosthesis, the St. Jude Medical. Age ranged from 11 to 69 years (mean 49). There were seven death within thirty days after the surgery (AVR 1, MVR 5, DVR 1). Follow-up is complete and ranges from 1 month to 107 months (total 392, 4 patient-year (pt-yr), AVR 127.7 pt-yr, MVR 182.6 pt-yr, DVR 82.0 pt-yr). In the AVR group, three late deaths have occurred and actuarial survival at 8 years is 89 +/- 5%. Five patients have sustained thromboembolic episodes from linearized rate of 4.7%/patients-year, and the probability of remaining free of thromboembolism at 8 years is 83 +/- 7% in survivors longer than thirty days after the surgery. In the MVR group, one late death has occurred and actuarial survival at 8 years is 87 +/- 5%. Two patients have sustained thromboembolic episodes from linearized rate of 1.1%/patient-years, and the probability of remaining free of thromboembolism at 8 years is 86 +/- 1% in survivors longer than thirty days after the surgery. In the DVR group, four late deaths have occurred and actuarial survival at 8 years is 75 +/- 12%. Two patients have sustained thromboembolic episodes from linearized rate of 2.4%/patients-year, and the probability of remaining free of thromboembolism at 8 years is 85 +/- 5% in survivors longer than thirty days after the surgery. There is no significance of actuarial survival rate among three groups, but the rate of thromboembolism in AVR group is significantly higher than in other MVR and DVR groups in the first 20 months. Reoperation was carried out in one patient because of perivalvular leak. There have been no thromboses of the SJM valve and no mechanical valve failure. Because of this experience, The St. Jude Medical heart valve prosthesis is our prosthesis of choice for any patient undergoing valve replacement with a mechanical prosthesis.

摘要

1980年1月至1988年12月,118例患者接受了主动脉瓣(AVR)置换术(45例)、二尖瓣(MVR)置换术(55例)、主动脉瓣和二尖瓣联合置换术(DVR)(21例),均使用圣犹达医疗公司的倾斜碟瓣人工瓣膜。年龄范围为11至69岁(平均49岁)。术后30天内有7例死亡(AVR 1例,MVR 5例,DVR 1例)。随访完整,时间范围从1个月至107个月(总计392患者年,4患者年(pt-yr),AVR为127.7患者年,MVR为182.6患者年,DVR为82.0患者年)。在AVR组,发生了3例晚期死亡,8年时的精算生存率为89±5%。5例患者发生血栓栓塞事件,线性发生率为4.7%/患者年,术后存活超过30天的患者在8年时无血栓栓塞的概率为83±7%。在MVR组,发生了1例晚期死亡,8年时的精算生存率为87±5%。2例患者发生血栓栓塞事件,线性发生率为1.1%/患者年,术后存活超过30天的患者在8年时无血栓栓塞的概率为86±1%。在DVR组,发生了4例晚期死亡,8年时的精算生存率为75±12%。2例患者发生血栓栓塞事件,线性发生率为2.4%/患者年,术后存活超过30天的患者在8年时无血栓栓塞的概率为85±5%。三组之间的精算生存率无显著差异,但AVR组在前20个月的血栓栓塞发生率显著高于其他MVR组和DVR组。1例患者因瓣周漏进行了再次手术。未发生圣犹达医疗瓣膜的血栓形成,也未出现机械瓣膜故障。基于此经验,圣犹达医疗心脏瓣膜假体是我们为任何接受机械假体瓣膜置换患者的首选假体。

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